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Prevalence of nonclassic congenital adrenal hyperplasia in Turkish children presenting with premature pubarche, hirsutism, or oligomenorrhoea.
[congenital adrenal hyperplasia]
Background
.
Nonclassic
congenital
adrenal
hyperplasia
(
NCAH
)
,
caused
by
mutations
in
the
gene
encoding
21
-
hydroxylase
,
is
a
common
autosomal
recessive
disorder
.
In
the
present
work
,
our
aim
was
to
determine
the
prevalence
of
NCAH
presenting
as
premature
pubarche
(
PP
)
,
hirsutism
,
or
polycystic
ovarian
syndrome
(
PCOS
)
and
to
evaluate
the
molecular
spectrum
of
CYP
21
A
2
mutations
in
NCAH
patients
.
Methods
.
A
total
of
126
patients
(
122
females
,
4
males
)
with
PP
,
hirsutism
,
or
PCOS
were
included
in
the
present
study
.
All
patients
underwent
an
ACTH
stimulation
test
.
NCAH
was
considered
to
be
present
when
the
stimulated
17
-
hydroxyprogesterone
plasma
level
was
>
10
 
ng
/
mL
.
Results
.
Seventy
-
one
of
the
126
patients
(
56
%
)
presented
with
PP
,
29
(
23
%
)
with
PCOS
,
and
26
(
21
%
)
with
hirsutism
.
Six
patients
(
4
,
7
%
)
were
diagnosed
with
NCAH
based
on
mutational
analysis
.
Four
different
mutations
(
Q
318
X
,
P
30
L
,
V
281
L
,
and
P
453
S
)
were
found
in
six
NCAH
patients
.
One
patient
with
NCAH
was
a
compound
heterozygote
for
this
mutation
,
and
five
were
heterozygous
.
Conclusion
.
NCAH
should
be
considered
as
a
differential
diagnosis
in
patients
presenting
with
PP
,
hirsutism
,
and
PCOS
,
especially
in
countries
in
which
consanguineous
marriages
are
prevalent
.
Diseases
Validation
Diseases presenting
"hirsutism"
symptom
aromatase deficiency
coats disease
congenital adrenal hyperplasia
cushing syndrome
kabuki syndrome
monosomy 21
This symptom has already been validated